Healthcare Provider Details

I. General information

NPI: 1770401549
Provider Name (Legal Business Name): EVORA HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7442 TOTTENHAM DR
WHITE PLAINS MD
20695-4447
US

IV. Provider business mailing address

7442 TOTTENHAM DR
WHITE PLAINS MD
20695-4447
US

V. Phone/Fax

Practice location:
  • Phone: 301-259-1889
  • Fax:
Mailing address:
  • Phone: 301-259-1889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: YANAPOLI FOFANAH
Title or Position: CEO
Credential: PMP
Phone: 301-259-1889